Norwegian Red Cross International Programs and Activities

In line with its humanitarian mandate, the  Red Cross Red Crescent  Movement may also temporarily substitute the health system during acute crisis and/or in selected protracted crisis.

Community-based health and first aid (CBHFA) is the Red Cross Red Crescent approach to empower communities and their volunteers to take charge of their health. By using simple tools which are adapted to the local context, communities can be mobilized to address priority health needs.

One example is 18-year old Shaeda, who teaches women to wash their hands with soap and clean water to prevent diseases and infections. She is a female volunteer in Dur Muhammad Baohri in Pakistan, which consists of around 400 people divided in 60 households.

With support from the Norwegian Red Cross, the Pakistan Red Crescent branch in Jacobabad started a project to train volunteers to raise awareness around health risks in the village, suggest solutions and decide what recourses are needed.

According to the village leaders, change has taken place in the village, especially in personal hygiene where better cleaning routines has led to less diseases.

The first support from the Norwegian Red Cross in this area was by introducing mobile health units in 2011, following the massive floods in 2010. 

The Norwegian Red Cross approach to health in protracted crisis is a combination of clinical and preventive health response. 

In Lebanon, the Norwegian Red Cross is funding Mobile Medical Unites (MMU), operated by Lebanon Red Cross.

This aims to contribute to the improvement of the health and well-being of vulnerable displaced Syrians, and host communities in Lebanon by ensuring improved access to basic primary health care services and social and psycho-social assistance. 

The clinics normally consists of a doctor, a nurse, a social worker and a volunteer. The mobility enables the team to travel to different locations and assist people with primary health services.

The Norwegian Red Cross supports partner national societies in provision of basic health care services, related to mother-, neonatal and child health.

In Afghanistan, Sima (24), gave birth to a healthy baby girl at a health clinic in Chaher Sang in May 2016. Sima had a problem with her placenta and was lucky to be in the health clinic while she was delivering. Without professional assistance, she could have died from this complication. The health clinic is run by Afghanistan Red Crescent, with support from the Norwegian Red Cross, and it receives around 100-110 patients every day. It covers an area of 23,000 people and it’s open six days a week. The clinic has seven staff members, including guards. Chaher Sang is located around 30 kilometers outside Mazar E-Sharif, north in Afghanistan.

Access to safe water, proper sanitation and practicing hygiene is imperative for all, both in ordinary times as well as in emergencies. Addressing WASH needs of communities affected by disasters and other emergencies, needs collective and coordinated efforts.

During the conflict in Syria, much of the infrastructure including electricity supplies and many water systems have been destroyed. Pumps and other equipment were stolen and water systems were not maintained, which has led to further deterioration.  This has caused people to flee, turn to use other less safe drinking water sources or forced people into using their limited resources on buying water, leading to suffering and dire humanitarian needs.

The Norwegian Red Cross works with Syrian Arab Red Crescent (SARC) to rehabilitate water systems. This improves peoples living conditions and protects their health. It will also enable people to return to their areas starting to rebuild their lives and livelihoods where possible. In 2017 Norwegian Red Cross supported The Syrian Arab Red Crescent, together with other partners, to successfully rehabilitate the main water sources at Figeh, which supplies a large part of the population of Damascus with water after the sources were partly destroyed in December 2016.  

The use of participatory approaches for post-disaster recovery and reconstruction is used both in urban and rural areas. The scale of present interest and the widespread acceptance of these methods suggest that their application will continue to grow. When home-owners are encouraged to take the lead in the reconstruction process, the variety of design of houses and settlements demonstrate a vitality of the building culture and local construction practices.

In April 2015, two earthquakes of 7,8 and 7,4 magnitude hit Nepal. More than 8,800 people were killed and infrastructure got severely damaged, including water supply, schools, hospitals and housing. In the recovery following the earthquakes, the Norwegian Red Cross, together with the IFRC and other national societies, focused on rebuilding houses by working with the owners to ensure more resilience to future chock or stress.

Disaster preparedness refers to measures taken to reduce the effects of disasters before they happen, either by a National Society or by communities themselves. The Norwegian Red Cross works with partner national societies on different levels of disaster preparedness.

In Myanmar, in cooperation with the IFRC, the Norwegian Red Cross supported the introduction of a new budget line in Myanmar Red Cross Society (MRCS) called “crisis modifier”. In short, this is funding that can be used for immediate response to small-scale disasters in case there is a need during the year.

The key advantage is that response is not depending on the need to go through budget reallocation discussions, requiring additional administrative work. In Myanmar, this enabled MRCS to respond to an evacuation of civilians after 225 civilian migrant workers were caught between conflicting parties in Awng Lawt village in April 2018. MRCS was able to evacuate the trapped civilians to a temporary rescue camp, set up at the premises of the Kachin Baptist Church were people were given food, non-food items and medical attention before they were sent back to their homes. 

The Norwegian Red Cross approach to health in emergencies is a combination of clinical and preventive health response. The Norwegian Red Cross is committed to shift from a merely reactive response mechanism to a risk-based approach, building on global surveillance, matching competencies in multisector teams for optimal efficient and effective response. 

Public health in emergencies focuses on population-based health care in emergency and disaster contexts and can be wide and varying depending on the underlying health of the population, the strength of the health system and the impact of the hazard. 

Health care provision in emergencies is often complicated by lack of information, particularly relating to real-time data on health issues and where help is needed. As a means to meet this challenge, the Norwegian Red Cross has spearheaded the development of a community-based surveillance system which aims to gather timely information directly from the affected communities. By allowing for people themselves to report on health situations, we can ensure that help is provided in the right place at the right time. In other words, Community-Based Surveillance (CBS) is the use of input from communities themselves to collect, analyse and interpret information on local health risks to prevent, identify and respond to disease outbreaks. As early warning of health risks leads to early action and lives saved, community-based surveillance can stop disease outbreaks from turning into large scale epidemics and pandemics.

Public health in emergencies overlaps with psychosocial support and WASH activities under this definition. This complementarity will strengthen both WASH and Health outcomes.

The Norwegian Red Cross has a specific role in emergency health, specifically related to deployments of “Emergency Response Units (ERUs)”. An ERU is a standardized package of trained personnel and modules of equipment, ready to be deployed on short notice. The units are fully self-sufficient for one month and can be deployed for up to four months.

The Norwegian Red Cross can deploy both Red Cross Emergency Hospital ERU (WHO EMT Type 2) and Red Cross Emergency Clinic ERU (WHO EMT Type 1) and public health in emergency. The latest ERU Hospital was opened in Cox Bazar to provide vital healthcare to thousands of people from Myanmar and local population living in dire conditions. The 60-bed hospital had the size of two football fields, had three wards, an operating theatre, delivery suite with maternity ward, psychosocial support, an outpatient department and an isolation unit. The hospital was run by the Norwegian and the Finish Red Cross and was staffed with a team of 30 international staff, in addition to 15 doctors and 30 midwifes from the Bangladesh Red Crescent society. In addition, the team provided psychosocial support to in-patients. They could treat an average of 1000 patients a week. 

After a disaster, the arrival of Red Cross Red Crescent staff and volunteers is often the first sign to people affected that their cry for help has been heard and that assistance is on its way. National Society community, branch and national response teams play a crucial role as first responders. They understand local needs, capacities and vulnerabilities. The volunteers can immediately take life-saving actions such as search and rescue, first aid, and evacuation.

This is reinforced with the provision of basic needs including food and emergency health care, shelter, clean water and sanitary conditions. Overall, as an outcome of any disaster response operation, we aim to achieve safer, more resilient communities and stronger, better prepared National Societies.

In DPRK, the Norwegian Red Cross works together with DPKR Red Cross, to further strengthen their capacity to respond to disasters, like flash floods, drought and other natural disasters. The Norwegian Red Cross supports their work in 15 districts, including improved access to safe water, hygiene and sanitation. This is done by creating wells with electrical pump systems or by taking advantage of gravity. Volunteers are also trained in teaching basic hygiene promotion to prevent diseases. 

The Norwegian Red Cross work to protect civilians from weapons by supporting the International Committee of the Red Cross (ICRC) and National Societies in advocating for states to respect International humanitarian law, and train National Societies in protecting their communities from risks from weapon contamination. This includes protection of humanitarian operations, civilians and volunteers and staff in the Red Cross and Red Crescent Movement from Landmines, cluster munitions and other weapons, including chemical, biological, radioactive and nuclear agents. 

Health Care in Danger (HCiD) is an initiative of the International Red Cross and Red Crescent Movement aimed at addressing the issue of violence against patients, health workers, facilities and vehicles, and ensuring safe access to and delivery of health care in armed conflict and other emergencies. The Norwegian Red Cross has played a key role in this initiative and have contributed to the global work through the International Committee of the Red Cross (ICRC), as well as bilateral project in several national societies.

The Norwegian Red Cross is working with the Honduran Red Cross to contribute to the reduction of risks faced by health services as a result of violent acts provoked by criminal organized groups. This is done through strengthening the National Health Authorities’ capacity to improve the security of health workers, through facilitating the implementation of security guidelines for health providers working in areas exposed to violence and to improve the Honduran Red Cross organizational capacity to implement security measures. 

The destructive force of urban violence on people's lives and livelihoods, and the suffering it causes, is a major concern of the Red Cross in many contexts in which it works around the world. Urban violence is often symptomatic of the socio-economic pressures linked to rapid urbanization, soaring population growth and large population movements. To mitigate the humanitarian consequences of urban violence, specially access to health, mobility, recruitment and sexual violence, Norwegian Red Cross and Colombia Red Cross has developed an integrated approach targeting neighbourhoods in Cali, Colombia.

The approach entails protection dialogue with armed actors (in close coordination with the International Committee of the Red Cross), strengthening communities’ self-protection mechanisms, improved assistance to victims including health services and accompaniment through referral routes to other service providers and simple livelihood interventions. The project aims to reach its objectives following three main paths. It focuses on assisting centres for imprisoned youths to ease on the reintegration process. It emphasizes on protecting educational institutions and communities affected by violence and lastly it aim to strengthen the protection of the Medical Mission to ensure access to health care in violence prone areas. 

Rates of Sexual and Gender Based Violence (SGBV) remain high globally in all settings. Though women and girls are overwhelmingly the targets of SGBV, men and boys can also be subject to SGBV. Pre-existing high rates of SGBV in “normal” times may increase the prevalence and risk of SGBV in crisis settings. The risk of SGBV grows in emergencies during which systems of protection and security collapse, and stress and the use of harmful coping mechanisms grow. In armed conflict, one form of SGBV, sexual violence (SV), can become so widespread and systematic that it is considered a "strategy or tactic" of warfare and can escalate into a crime against humanity, a war crime or an act of genocide. In many of the settings the Norwegian Red Cross works in, all of these factors can concur at the same time.

The ICRC focus on SV in conflict and other situation of violence (OSV), the IFRC‘s role in disasters and emergencies and the National Societies’ presence before, during and after crisis make it possible to address the whole spectrum of SGBV. At the operational level the Norwegian Red Cross supports health response and psychosocial support for survivors through ICRC or partner National Societies. At the global level focus has been on dialogue with States and other authorities for them to respect the rights of civilians, fulfil their obligations under international law in order to protect their populations against SGBV. Special focus together with the ICRC has been in engaging state armed forces in dialogue on the prohibition of SV in selected contexts. Currently the Norwegian Red Cross works with Movement partners to strengthen the evidence base to better understand humanitarian issues linked to SGBV and provide concrete guidance on how to effectively address them in their operations. 

The Norwegian Red Cross supports the Red Cross and Red Crescent Movement in its work to protect schools and access to education. The Movement decided in 2017 to make education a priority, and Norwegian Red Cross will actively assist exploring what role the Movements staff and volunteers can play. 

Gendered norms, including roles, expectations, attitudes and behaviours, that exist in all societies, also during peace time, become exacerbated during emergencies, conflict and protracted crisis. Indeed, gender and other social factors shape the extent to which men, women, boys and girls are vulnerable to and affected by emergencies and what resources they have in coping with hardships and violence. Being aware of local gendered norms and existing diversities help to understand these different needs and risks which must be recognized and incorporated into our response. At an overall level, when aiming at “(…) meeting the needs of the most vulnerable people” one will not be successful without properly assessing who (what individuals or groups) are in fact the most vulnerable; to what risks and why.

In 2018, the Minimum Standards for Protection, Gender and Inclusion in Emergencies, IFRC (MS PGIiE) have been revised and launch is in the pipeline. Norwegian Red Cross commits to these standards and have been a key supporter both technically and financially of the development of this tool, its importance, and the overall Area of Focus of PGI in the movement. This means that all partnerships, project- and program-cycle processes, and activities on the ground supported or implemented by Norwegian Red Cross, must reflect efforts to meet these standards - DAPS framework; Dignity, Access, Participation and Safety.

Good governance and sound financial management are crucial to support strong, sustainable and accountable National Societies as humanitarian actors. Sound financial management requires financial accountability and transparency, adherence to policies and procedures, financial controls and reporting.

Financial Development is more wide-ranging than just improving one area, for example how accounting is done. It is about improved integrity, financial transparency, financial stability, budgetary discipline, strategic decisions, revenue mobilization, sustainability and accountability.  

The Norwegian Red Cross supports National Societies within Financial Development in all regions, covering a wide range of areas, first depending upon the results of the financial assessment as a baseline for support.

One of the National Societies that has been supported is the Lebanese Red Cross (LRC). They sought to institute significant change quickly and efficiently. With the support of a local consultancy firm, the organization's financial development needs were assessed, and recommendations made and implemented. Financial management systems and procedures were reviewed and enhanced, and most importantly, qualified staff were recruited and empowered to manage the department. Among others, financial reporting improved significantly as a result, which increased the credibility of the Lebanese Red Cross with internal and external stakeholders. After updating of the financial system at the headquarters a process is currently ongoing at the branch level of the National Society. 

Given the strategic focus on National Society Development, technical and financial support was also provided to the Lebanese Red Cross (LRC) in Resource Mobilisation. This process started in 2013 with a market study to better understand the public perception of LRC and the potential for both individual and corporate fundraising. The market study confirmed LRC’s strong image and reputation and showed that a clear majority of the respondents were more than willing to support LRC financially but lacked information about what LRC needed and how they could contribute.

Based on the market study a fundraising strategy was developed including a common vision and mission for fundraising, fundraising objectives and an action plan for 2014-2018. This strategy was approved in 2014 with a focus on corporate fundraising and LRC hired its first-ever fundraising officer. As part of its fundraising plan LRC focused its attention on corporate fundraising, resulting in several partnerships.

At first LRC achieved a royalty type partnership with Café Super Brazil, one of the second largest coffee producers in Lebanon, to contribute a minimum of $65,000. An illustrative example was a post on Café Super Brazil's Facebook page: “I don’t drink coffee, but I bought a few packs because you are supporting the Lebanese Red Cross.”  Another successful partnership was reached after that with the Bank of Beirut, worth more than $300,000.

The external fundraising initiatives were not as many in numbers as outlined by the strategy and Plan of Action, and they some time to be concluded but also showed the organisation that professional and systematic fundraising could achieve results surpassing even the highest expectations. The fundraising team's approach to potential donors was courageous and relied on the market study results which highlighted LRC's potential.